Possibilidade de aplicação da economic duress no direito brasileiro

Esta tese trata da possibilidade de recepção, no direito brasileiro, de uma figura proveniente da common law: a economic duress, que se constitui de prática de ameaças de prejuízo econômico no processo de contratação ou de modificação contratual em relações comerciais. Para que este exame fosse realizado, a primeira parte da tese tratou de três das principais espécies de duress reconhecidas na common law: a physical duress, a duress of goods e a economic duress. Foram analisados os requisitos para a configuração da economic duress, bem como o seu campo de aplicação, a saber: a ameaça de descumprimento contratual, de não realização de contratos futuros e de proposição de ação judicial, inclusive aos meios de subsistência da parte que sofre a ameaça. Na segunda parte da tese, analisaram-se as três possíveis vias pelas quais a economic duress poderia ser recepcionada no direito brasileiro: a lesão, o abuso do direito e a própria coação.This thesis analyzed the possible reception of economic duress into Brazilian Law. Economic duress, a concept originated in common law, relates to the use of threats that may lead to financial distress during the formation or modification of corporate contracts. The first part of this thesis discussed the three main types of duress in common law: physical duress, duress of goods and economic duress. The elements that define economic duress were then analyzed, as well as the situations to which it applies, namely: threats to breach the contract, not to contract again in the future and to pursue legal remedy, as well as threats against the subsistence of the threatened party. In the second part, three possible paths for the reception of economic duress into Brazilian Law were examined: unconscionability, abuse of right and duress

A Self-Management Training Intervention: Perceptions and Practices of Community Health Workers in South Africa

Background. While community health workers (CHWs) are increasingly being used as a strategy for increasing health care access, particularly in rural communities, interventions are needed to improve their skill sets in inspiring health behavior change, both for themselves and among their community clients. Self-management (SM) education interventions have shown to improve health behaviors and wellbeing. Purpose

Six Months In: We Surge On

Steve Jobs created Apple in a garage. Facebook emerged out of a college dorm room. And so, like all good (and equally famous) things, the idea for Surge began in the Plank basement. As seniors, and admittedly all bonafide social justice enthusiasts, we wanted to expand the movement at Gettysburg College and leave our mark. [excerpt

PLANO DE PARTO: atribuições e contribuições do profissional enfermeiro na atenção primária em saúde

Introduction: the Birth Plan is a document prepared by the pregnant woman and the health professional who performs prenatal care, expressing the wishes and expectations of pregnant women about childbirth. Objective: to analyze the attributions and contributions of the professional nurse in the elaboration of the Birth Plan during prenatal care in health units. Method: The research has a descriptive and exploratory character, with a qualitative approach, and data collection was carried out through semi-structured interviews with eight professional nurses from Basic Health Units in a city in Rio Grande do Sul. Data analysis and discussion took place using the Content Analysis method, with four thematic categories being elaborated. Results: as the main results of the research, it is highlighted that, for the most part, professionals are aware of the Birth Plan, however, they do not carry it out. As for the nurses' attributions in the elaboration of the document, the results showed the professional as an incentive in the elaboration of the Birth Plan, as well as their role of informing, guiding and teaching. The lack of communication between the public health teams and the hospital area was highlighted as a complicating factor, still, the importance of the bond between the professional and the pregnant woman was the main facilitating factor. Regarding the performance of the teams, public health and the hospital area, the need for reception, support and receptivity of these teams with the pregnant woman is highlighted, in addition to the important creation of bonds between the teams. The importance of empowering the pregnant woman and the return of the protagonism and autonomy of the pregnant woman in labor is also highlighted. Conclusion: the Birth Plan is an important tool for reducing unnecessary interventions, as well as contributing to a humanized and qualified assistance in the birth process by the professional nurse. Keywords: Prenatal Care; Nurses; Public Health Services; Patient Care Planning.Introdução: o Plano de Parto é um documento elaborado pela gestante e o profissional de saúde que realiza o pré-natal, manifestando os desejos e expectativas das gestantes acerca do parto. Objetivo: analisar as atribuições e contribuições do profissional enfermeiro na elaboração do Plano de Parto durante o pré-natal em unidades de saúde. Método: a pesquisa tem caráter descritivo e exploratório, de abordagem qualitativa, sendo a coleta de dados realizada através de entrevistas semiestruturadas com oito profissionais enfermeiros de Unidades Básicas de Saúde de um município do Rio Grande do Sul. A análise e discussão dos dados ocorreram pelo método de Análise de Conteúdo, sendo elaboradas quatro categorias temáticas. Resultados: como principais resultados da pesquisa, destaca- se que, em sua maioria, os profissionais têm conhecimento sobre o Plano de Parto, porém, não o realizam. Quanto às atribuições do enfermeiro na elaboração do documento, os resultados apontaram o profissional como incentivador na elaboração do Plano de Parto, bem como, seu papel de informar, orientar e ensinar. A falta de comunicação entre as equipes de saúde pública e da área hospitalar foi destaque como fator dificultador. Ainda, a importância do vínculo entre o profissional e a gestante foi o principal fator facilitador. Sobre a atuação das equipes da saúde pública e da área hospitalar, destaca-se a necessidade do acolhimento, suporte e receptividades destas equipes com a gestante, além da importante criação de vínculo entre as equipes. Ainda, se destaca a importância do empoderamento da gestante e a devolução do protagonismo e autonomia da gestante no trabalho de parto. Conclusão: o Plano de Parto é uma importante ferramenta para a diminuição de intervenções desnecessárias, bem como, colabora para uma assistência humanizada e qualificada no processo de parto por parte do profissional enfermeiro. Palavras-Chave: Cuidado Pré-Natal; Enfermeiros; Serviços Públicos de Saúde; Planejamento de Assistência ao Paciente

Respostas eletrofisiológicas a diferentes isoformas de FSH em células humanas do cumulus oophorus : resultados preliminares

Objective The aim of the present study was to provide a better understanding of the specific action of two follicle-stimulating hormone (FSH) isoforms (β-follitropin and sheep FSH) on the membrane potential of human cumulus cells. Methods Electrophysiological data were associated with the characteristics of the patient, such as age and cause of infertility. The membrane potential of cumulus cells was recorded with borosilicate microelectrodes filled with KCl (3 M) with tip resistance of 15 to 25 MΩ. Sheep FSH and β-follitropin were topically administered onto the cells after stabilization of the resting potential for at least 5 minutes. Results In cumulus cells, the mean resting membrane potential was - 34.02 2.04 mV (n ¼ 14). The mean membrane resistance was 16.5 1.8 MΩ (n ¼ 14). Sheep FSH (4 mUI/mL) and β-follitropin (4 mUI/mL) produced depolarization in the membrane potential 180 and 120 seconds after the administration of the hormone, respectively. Conclusion Both FSH isoforms induced similar depolarization patterns, but β-follitropin presented a faster response. A better understanding of the differences of the effects of FSH isoforms on cell membrane potential shall contribute to improve the use of gonadotrophins in fertility treatments.Objetivo O objetivo do presente estudo foi fornecer uma melhor compreensão da ação específica de duas isoformas de hormônio folículo estimulante (FSH, sigla em inglês) (β-folitropina e FSH ovino) no potencial de membrana de células do cumulus oophorus humanas. Métodos Dados eletrofisiológicos foram associados às características da paciente, como idade e causa da infertilidade. O potencial de membrana das células do cumulus foi registrado com microeletrodos de borossilicato preenchidos com KCl (3 M) com uma resistência de 15 a 25 MΩ. O FSH ovino e a β-folitropina foram administrados topicamente nas células após a estabilização do potencial de repouso durante pelo menos 5 minutos. Resultados Nas células do cumulus, o potencial médio de membrana em repouso foi de -34,02 2,04 mV (n ¼ 14). A resistência média da membrana foi de 16,5 1,8 MΩ (n ¼ 14). O FSH ovino (4 mUI/mL) e a β-folitropina (4 mUI/mL) produziram despolarização no potencial de membrana 180 e 120 segundos após a aplicação do hormônio, respectivamente. Conclusão Ambas as isoformas de FSH induzem padrões de despolarização semelhantes, mas a β-folitropina apresentou uma resposta mais rápida. Uma melhor compreensão das diferenças dos efeitos das isoformas do FSH no potencial da membrana celular contribuirá para aprimorar o uso das gonadotrofinas no estímulo ovariano controlado e em protocolos de maturação oocitária in vitro

Apósitos utilizados para prevención de infección del sitio quirúrgico en el posoperatorio de cirugía cardiaca: revisión integrativa

Objective: To identify and describe which dressings are recommended to prevent surgical site infection in hospitalized adult patients after cardiac surgeries. Method: Integrative review carried out in the databases MEDLINE, LILACS, CINAHL, Web of Science, Cochrane and Scopus. Studies related to dressing in the postoperative period of cardiac surgery were selected. Results: Seven articles were included, with the following dressings: negative pressure wound therapy, silver nylon dressing, transdermal delivery of continuous oxygen and impermeable adhesive drape. The dressings that led to reduction of infection were negative pressure and silver nylon dressings. Conclusion: It was not possible to identify which dressing is most recommended, however, some studies show that certain types of dressings were related to the reduction of infection. Clinical trials with a rigorous methodological design and representative samples able to minimize the risk of bias should be conducted to evaluate the effectiveness of dressings in the prevention of surgical site infection

Assessment of risk factors for Non-Communicable diseases among a cohort of community health workers in Western Cape, South Africa

Community Health Workers (CHWs) have been identified as the key health professionals to drive the agenda of the prevention of health risk behaviours, linked to noncommunicable diseases (NCDs) in South Africa. They are regarded as the agents of change, who will provide impetus to the achievement of the health behaviour goals, set out by the South African National Department of Health1 . However, this cohort, may suffer from an array of NCDs. There are various risk factors that influence the health of individuals and contribute to NCDs, including modifiable and non-modifiable risk factors, which cannot be changed, or altered by an intervention, such as age, family history, gender and ethnicity2,3. Modifiable risk factors have been classified as behavioural, physical, and biological4 . Globally, NCDs are responsible for 80% of premature deaths in LMICs5,6. In response to the NCD pandemic, the World Health Organisation (WHO) set a global target in 2012, which was aimed at reducing premature deaths, caused by NCDs, by 25%, by the year 20257 . However, this goal will require drastic, immediate, and targeted approaches that address the root causes of NCDs. South Africa has followed the global trend, and evidence depicts an increase in NCDs8 , with a 27% probability of dying between the ages of 30 and 70 years, as a result of cardiovascular diseases (CVDs), diabetes, cancers, or chronic respiratory conditions7,9. This is similar to other countries such as India (26%), Philippines (28%), Democratic People’s Republic of Korea (27%), Mali (26%), Russian Federation (30%), Ukraine (28%) , Tajikistan (29%), Fiji (31%), Afghanistan (31%) and Armenia (31%)9 In the Western Cape, the prevalence of chronic diseases of lifestyle raises major concerns about the communities’ health risk behaviour. The Burden of Disease Survey for the Western Cape, which was released on 24 April 2017, reported that NCDs contributed to 61% of deaths in the Western Province1

Myocardial aging as a T-cell–mediated phenomenon

In recent years, the myocardium has been rediscovered under the lenses of immunology, and lymphocytes have been implicated in the pathogenesis of cardiomyopathies with different etiologies. Aging is an important risk factor for heart diseases, and it also has impact on the immune system. Thus, we sought to determine whether immunological activity would influence myocardial structure and function in elderly mice. Morphological, functional, and molecular analyses revealed that the age-related myocardial impairment occurs in parallel with shifts in the composition of tissue-resident leukocytes and with an accumulation of activated CD4+ Foxp3- (forkhead box P3) IFN-γ+ T cells in the heart-draining lymph nodes. A comprehensive characterization of different aged immune-deficient mouse strains revealed that T cells significantly contribute to age-related myocardial inflammation and functional decline. Upon adoptive cell transfer, the T cells isolated from the mediastinal lymph node (med-LN) of aged animals exhibited increased cardiotropism, compared with cells purified from young donors or from other irrelevant sites. Nevertheless, these cells caused rather mild effects on cardiac functionality, indicating that myocardial aging might stem from a combination of intrinsic and extrinsic (immunological) factors. Taken together, the data herein presented indicate that heart-directed immune responses may spontaneously arise in the elderly, even in the absence of a clear tissue damage or concomitant infection. These observations might shed new light on the emerging role of T cells in myocardial diseases, which primarily affect the elderly population.info:eu-repo/semantics/publishedVersio

Receiving the initial Down syndrome diagnosis: a comparison of prenatal and postnatal parent group experiences

This study explored the preliminary experiences of parents upon learning of their child's diagnosis of Down syndrome. Qualitative data from a web-based, national survey were analyzed based on two groups: prenatal (n  =  46) or postnatal (n  =  115) diagnosis. Three primary categories emerged from the data analysis: prenatal screening/testing decisions by parents, the adjustment process for parents, and postdiagnosis resources and support for parents. Participants' rationale behind pursuing testing ranged from wanting to be better prepared to not pursuing testing because it was not a factor in continuing the pregnancy. Participant reactions to the diagnosis involved a range of intense preliminary emotions; participants described their extreme grief and loss experience at the initial news of the diagnosis, which also was ambiguous in nature and required differing timelines of adjustment. Finally, participants described experiences with medical professionals, information/education, and faith/religion as resources and areas of support, although not all were described as positive in nature. Participants in both groups identified having negative experiences with medical professionals during the diagnosis process. The results indicated the importance of these early experiences for parents of children with Down syndrome and emphasize providing effective education, resources, and practical information from reliable sources